Juss

ETC, Earl Thomas Conley passed away without recognition despite having 18 number one hits and everyone forgetting him for “thinking man country.” He sang my life. Anyone that listens to real country and not Luke Bryan or Luke Combs (don't insult me) will know who this is. Holding Her and Loving You Once in a Blue Moon (Know This to Well) Fire and Smoke (Christ it's like he read me and sang my life) That was a close one (even us wild eye southern rebels have a soft side)

Thank you. Maryland is unique in that on one end we have mountains (up to I thinK 3,000 feet) and on the another extreme, 3.5 hours away full-on beach (you guys would call it an ocean). It's small enough in milage that a tropical storm can reach the first mountain range, the Catoctin Mountains, which is where this was taken (Outside Ellicott City, HOCO, Howard County). You also have Appalachia, and God some mountain range way out in bumfu#% Garret County. We also used to have blizzards and where I lived averaged 40 inches of snow. The last bad winter was 2010, we had a 3-foot blizzard, then another, followed a week later by another. Anyway, I went out in a state of an emergency under the guise that I had an electrical hazard that was pending fire hazard, and that I needed to rewire and fix some things. And, from there, we took my panel work van (if not obvious) and snuck out to a state park. The rest follows. I was a former idiot that surfed in Hurricanes and so, a waterfall didn't scare me. Yes, to the point if any bigger I would have been towed into the wave. The rest are from Balwmer (how we pronounce it) or where I miss and hope to live again my old stomping grounds-Old EC (Ellicott City). Aside from the political aspect, it's a great state. We have the best hospitals, universities, and they say it is expensive, but compared to other locations you can make significantly more.

Happy Thanksgiving, on the following day. I hope that all went well and you were pain free, and I hope that everyone was pain free, or fairing as best possible. Stay strong, it does get better.

Also @BoscoPikoand @Shaun brearleyI am not smart. If I was, I would have attended an A list university such as Emory or Washington University, soft Ivy League like Johns Hopkins, or Ivy League such as the Wharton School of Business, as all of my past friends did. I attended flipping University of Baltimore on full scholarship as an honors student. The only thing it is known for is its top 20 law program, national best taxation program, and in undergrad the Urban Development and Economic Planning program that I was involved in, and Accounting. I was a dual major. The point is I am just average at best. I think that I read things properly and am desperately trying to communicate properly with others. If anything, with the medical and all research, it is a matter of just taking your time, filtering the important and relevant information, and then processing it. It appears overwhelming, but you can easily go thru a few thousand pages per day if you learn how to properly skim said information and find what is pertinent. Honestly, purchase a medical dictionary, be patient it isn’t anywhere near the perplexity one makes it out to be. Cogito Ergo Sum. It isn’t like reading a classic such as Dosetstchesky or a great post modern by DeLillo. Respectfully, this isn’t an attempt to understand Kant’s deontological ethics, or even more obtuse Tractus Logico-Philosophicus by Witttengstein.

Hydroxyzine is a far more potent and cheaper (if you have good insurance) method to the antihistamine approach if you follow. It is a second generation H1 antihistamine. Benadryl is one way, this a cheaper down and dirty method than the H1 target approach that people think of. The first generation H1 Antihistamines are the ones legendary for all the problems and include clozaril and amitriptyline. I think the first generation broke the blood-brain barrier, the second doesn’t. The only one of the second gen worthwhile is Hydroxyzine, the rest like Claritin serve no purpose. Its straightforward. If you want to really not pass go take a Haloperidol

I’m serious, and I never followed that type of music scene, I didn’t know Amy Winehouse (had to StartPage). I respect others tastes, definitely not my style. I must have been under a rock when she was famous. Wow, where was I?

@Shaun brearleyUnfortunately the “specialist,” as they often demand to be called over on this side of the pond are not much better. Often with something like CH, you are subjected to experimentation, and if not careful, becoming a pharmaceutical lab rat. For the record, having being a well traveled patient with specialists and surgeons, all of those with CH seem to go through a similar battle. The only advantage that I or we have is in elective surgery, neuroimaging, and surgery. Canada is supposed to be the role model for your style of healthcare, and people fly to Poland, pay a $1,000 U.S. dollars to take an MRI and fly back. If not they won’t know the severity of the suspected cancer, and could wait much longer than 9 months. I can get an MRI the day the doctor or NP writes it, walk in. You tell me. And with surgery, if you have the right coverage, you will get exceptional surgical procedures. My point in all of this is, as of now, I don’t know what to think of neurologists in any type of healthcare system. Honestly, it doesn’t appear to be that convoluted and complicated, but I could be terribly wrong and hate to oversimplify such a devastating illness. The fundamental issue lies in profit and obtaining grants. Research grants are so damn limited and competitive that I just don’t see people in the U.S. excerpting the effort. The other issue lies in the fact that-and this by no means evidenced or medical based-I have never witnessed another illness whereby a drug works for one, fails in another, and so forth. Even the illicit options are that way. Perhaps that is why none of the pharmaceutical companies jumped on board? Again, in my ignorance I have never seen something so perplexing. Last, I am sorry for the late reply. Even I struggle, despite my experimental self-treatment. I got nailed with my headaches and was flat on my ass. My house manager came over, woke me up and told me you have to cook, remember? I was like, merde. Jesi li ozbijan? And, every hour I had to wake up baste the bird, and recently fix all the sides. The only abortive that I willl use is the antiemetic Phenergan, promethazine, but good luck. In my area it is easier to get a script for Lortab. That isn’t hyperbole. My Psych used to write it, now she can’t. She couldn’t get a script after her surgery. They push odanestron, but that does not cut it. And Phenergan came in every form that I prefer not to blast. Yes, nausea meds can make for good abortive medications. Last, and again not scientific, you must learn to knock your ass out when going through it. In a cruel twist of fate, it seems that most with CH end up dancing with the nasty bitch. With severe fibromyalgia and a exceptionally rare autoimmune condition known as Stiff Person Syndrome, I am always exhausted, and thus, with extreme pain, hydroxyzine helps in me black out. Good luck.

Unless I am missing something, all the drugs for CH are borrowed, “Off Label.” That doesn’t help things. Worse, abortive measures are split 50, none worked for me, or I robbed Peter to pay Paul. Even Oxygen is a chance, some try to present it as if it works for everyone. I have seen otherwise. I have my theories on how to prevent, but without a lab, willing test subjects, and being at University it won’t pan out. Besides, I’m not about to pan out several hundred thousand on a useless Biochem STEM major. Talk to people, I talked to several, they are my Uber and Lyft drivers, it is a useless major. That is why I don’t pursue it. And thus, I won’t be able to help you guys. My point, when I do return to University I will invest in what pays serious money, Urban Development and Economic Planning (Real Estate Development) and becoming a Quant. I will keep researching for you guys, but I don’t know, money talks bullshit walks, niche markets don’t get the drugs, less they stand to profit.

I think that I will start my morning with Jeff Beck, People Get Ready

@Shaun brearleyI understand and cannot give that medical advice for obvious reasons. For those of you that functioned well, the drug can be brutal. I am just far gone and don’t notice, and I do think you can counter but few try what I posted. The FDA and Big Pharma have a symbiotic relationship and so they pass drugs if they stand to profit. I thought that NHS and the EU had yet to approve CGRP use and was correct. It works as well, without the side effects (they claim). Give it a few years and all the evidence surfaces, somehow as if magical. Here is a charity in London that provides the CGRP, 4 options. It’s expensive, but about half the cost of the drug. AGAIN HALF THE COST OF THE DRUG! It should cost £524.96 and it costs £386.5 https://www.nationalmigrainecentre.org.uk/migraine-and-headaches/migraine-and-headache-factsheets/cgrp-and-anti-cgrp-injections-for-the-prevention-of-migraine/ I know with a common law system everything is different, we have 4 commonwealth states-don’t get a criminal charge in those states. A misdemeanor, I think they abolished that in the UK back in the 60s, can lead to a life sentence. These states operate much like the UK law system. Anyway, and so, I found the latest NHS guidelines on Food Supplements and FBO “The Food Informations Regulations Act 2014.” https://www.legislation.gov.uk/uksi/2014/1855/made/data.pdf Can you take food supplements? The Amino Acids, Vitamins, Minerals, do help. I’m sure someone can link you to the Vitamin D protocol. It seems some, especially with pure Cluster Headache, hitherto CH, are unfortunately, and disproportionately, unable to find a prophylactic. They seem to try drug after drug, without success. Even though I have multiple forms of headache, I didn’t get results until extensive tinkering and using the what you guys call food supplements. CH without Migraine is another animal, especially the episodic, and my concern is if that shit turns chronic. That happened to my Uncle. He was episodic for over 30, possibly 40 years, retires and goes chronic. How does that work? And, seriously? He tried everything, and my family is the type that won’t take medication if it were to save their life. I hope that this helps. And, the charity claims a 50% to 60% efficacy rate. I would suspect hire for migraine, and much lower for CH, and somewhere between the two of you have both. Good luck. I know that Thanksgiving is American, but perhaps you can reflect on all of your blessings for the year.

@BoscoPikothat is an excellent attitude to have on life, and I commend you or anyone that takes that approach. It is best if you do all that is possible to move forward and not let the illness define you. While I don’t let multiple illnesses define me, they have destroyed my life beyond repair. I spend every waking free moment trying to prevent others from walking my path in life. I pissed away numerous golden opportunities, and enormous potential. By 7th grade I was in all college level classes. I’m sure that seems impossible to believe, and it’s not to brag, but true. I did nothing with my life, but rack up debt, get in tons of trouble, and leave a path of destruction. Thus, as stated, I try to help everyone, with everything that I comprehend and have experience in. The worst thing when you have emotional or physical pain, worse, both, is to have idle time. You can take pills, go to therapy, worse bang dope, in the end, a simple fix-keep moving, keep busy. You have the perfect idea.

As we already know, Toprimate significantly impacts(on an fmri) signaling of the ACC (Anterior Cingulate Cortex and Gyrus), and causes basal ganglia activation. Dopamine receptor agonists and antagonists affect ACC activation impacting neuromodulatory regulation. Fellow crackpots understand that emotional numbing is caused by the deactivation of the ACC, above or below activation I do know causes psychpathologies. My guess is the “numb, flat, despondent” feeling is valid, problem is I’m already batshit crazy so I don’t notice it. For the rest of you, I bet that it is intense. Compounding the issue, I have had over 60 shock treatments in my life-that targets the ACC as well. Also, we all definitely know that Toprimate is designed to target the temporal lobes, which if it impacts you enough it can cause similar symptoms as: Difficulty in understanding spoken words, selective attention, difficulty with identifying and categorizing things, difficulty learning and retaining information, impaired factual and long-term memory, prosopagnosia, sexual interest can go up or down (you can f*%k like a blender on high speed, or be a prude, no in between), emotional disturbances (aggressive behavior, especially sexually aggressive behavior, I knew a Catholic Girl (never mind)). Now, you can counter this. But, I always state, “to be fair,” and I’m so far gone that Spicoli looks like a genius next to me. I hope that this helps.

I should have clarified, and in the CGRP inquiry posts that Toprimate seems to work best if you suffer from migraines or have migraines as well. Neither Toprimate or CGRP/Monoclonal seems to do much but piss in the wind for CH; however, if you add in the migraine factor the results can change dramatically. Please remember that I have an armchair M.D./PhD My headaches are convoluted, an obfuscated cacophony of CH, Migraine, and baseline, not discernible by Johns Hopkins, Jefferson (you know the doc) Georgetown (Dr. Daughtery is a top headache doc, nice but didn’t do a damn thing) GW (George Washington) (I don’t get myself there, it’s mainly trauma probably best place to go for surgical residency in the country for obvious reasons), GBMC (local does a ton of clinical trials a lot of good surgeons) Union Memorial (Top 50 Hospital affiliated with Cleveland clinic in Baltimore), despite me not going to a University of Maryland hospital with my head falling off I tried there, this could carry on. I gave up. I just see nurse practitioners now and get superior care. My point, I’m different. It works miracles for me, but for some I realize that it does absolutely nothing. Again, I have met enough people to notice that it appears to work best in people that also have migraines or migraines only. I don’t agree with sugar consumption, but even my NP’s agree with Toprimate, 32 ounces of Gatorade with your required water intake is a good idea. This restores the electrolyte balance and prevents stones, which, sadly, are about incontrovertible.

As I expected, the CGRP isn't as efficacious as touted. By comparison to the tried but true Toprimate, it does not fair any better. If not familiar with Meta-analysis you are applying quantitative epidemiological studies that assess results from prior case studies and clinical trials. In other words, you can't rely on a single study or trial, but when you combine multiple sources of data it generally tells all. Further, this isn't ghostwritten or funded by the pharmaceutical industry, and it was published through Springer. It is based by a reputable department of neurology in Germany (a good start), as the government is less in bed with the drug regulators. The FDA is not the watchdog that you think it is, far from it. While cronyism exists overseas, it occurs far less, and there is considerable more scrutiny. The point, this carries a lot of weight. From Indirect Comparison of Toprimate and Monoclonal Antibodies Against CGRP or It's Receptor for the Prophylaxis of Episodic Migraine: A Systematic Review With Meta-Analysis it does indicate that most can never reach the required 100mg of toprimate because of side effects that lead to discontinuation, but I'm telling you to stick with it, it is a miracle. If you set aside that issue, there isn't a difference. https://link.springer.com/content/pdf/10.1007/s40263-021-00834-9.pdf Next, I not only tinkered with “Dopamax/Stupamax/noassamax” I added clinically proven nutraceuticals to counter the infamous stupor and known 20% decline in cognition. Those are L-Theanine, L-Tyrosine, Phosphatidylserine (PS), Huperzia, and GABA. The only downside (for me) is that you turn into a manorexic, at this rate 70 inches and 140 pounds possibly 135 pounds seems quite realistic. I don't see why the ladies aren't flocking in droves paying millions for it. Some lose over 100 pounds. Hope this helped.

This is somewhat graphic, not a good idea to play around with the offended to my outlaw-minded. Here is something from the modern outlaw movement Tyler Childers, Wheeler Walker, Sturgill Simpson SIT ON MY FACE, again kinda graphic Wheeler is saving country music from the PC police, Go Big or Go Home I understand about the PBR, had plenty, here it is Natty Light, how else would I steam crabs? You can't steam crabs in the water. You need Natty Boh or Natty Light. Scuzz kills it When I heard this 7 years ago, I thought Waylon was resurrected in Sturgill’s body, these boys revived the entire outlaw movement in this song, and they knew it. Watch their facial expressions in the end, they knew Waylon was smiling down on them. Unlike the Frat Boy/Hussy Sorority Luke Bryan Country and Taylor Swift, this is the real deal. Everyone that follows the real country couldn't talk for days. I'm still impressed. There is still somewhat of an outlaw movement, sadly most went on to bluegrass. I can't describe it, real deal.

While pertinent to Migraine prophylaxis it gets you in the ballpark. And it includes nutraceutical and pharmaceutical approaches. Everyone writes it off, hell I did, 3x, then I researched, tinkered, and dialed in for two years, at high doses, topiramate is a huge help (drink a shitton of water or you will piss stones). The metabolic face of migraine https://orbi.uliege.be/bitstream/2268/247255/1/Gross et al Metabolic face of migraine-Nat Rev Neurol 2019.pdf Open-label prospective experience of supplementation with a fixed combination of Magnesium, B2, Feverfew, Andrographis Paniculta, and Coenzyme Q10, for Episodic Migraine Prophylaxis (Note: I added 3G of Niacin following Dr. Hoffer’s Studies from the 50s (I'm a pill-popping manic depressive crackpot, most only need 500mg), Butterbur, B12 (60,000% the RDA), I take C to the bowel (10, up to 50 Grams per day), crap I have to look at the rest. Oh, pyroxidine. There is more. It works.) https://mdpi-res.com/d_attachment/jcm/jcm-10-00067/article_deploy/jcm-10-00067.pdf

It is a biologic, or CGRP showing promise in migraine reduction both episodic and chronic, but I am speculative. Many I talked to tried Emgality when that was all the hype and that failed to deliver. To be fair, it appears case-by-case, and while one monoclonal may work great for some, may fail to work for others. For example, according to trials fremanezumab-vfrm is a poor performer, I had decent results, and better than average with botulinum toxin. As expected, I have this bizarre problem of developing tolerances and it stopped working. Here, these may help you: The CGRP Receptor: What Neurologists Need to Know https://www.scienceofmigraine.com/-/media/Themes/Amgen/ScienceOfMigraine/ScienceOfMigraine/documents/cgrp-receptor-what-neurologists-need-to-know.pdf The CGRP Receptor in Migraine https://www.scienceofmigraine.com/-/media/Themes/Amgen/ScienceOfMigraine/ScienceOfMigraine/documents/cgrp-receptor-migraine.pdf Monoclonal Antibodies and Small-Molecule Drugs: What General Neurologists Need to Know https://www.scienceofmigraine.com/-/media/Themes/Amgen/ScienceOfMigraine/ScienceOfMigraine/documents/monoclonal-antibodies-small-molecule-drugs-neurologists.pdf Characteristics of mAbs and small molecules https://www.scienceofmigraine.com/-/media/Themes/Amgen/ScienceOfMigraine/ScienceOfMigraine/documents/characteristics-therapeutic-mabs-small-molecules.pdf Eptinezumab: A calcitonin-gene-related peptide monoclonal antibody infusion for migraine prevention https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511911/pdf/10.1177_20503121211050186.pdf From Neurology Journals (prominent journal) it is showing a significant reduction. I'm still a skeptic, most major medical journals are ghostwritten, paid for by the pharmaceutical industry, and it is about impossible to separate fact from fiction. Efficacy and Safety of eptinezumab with Chronic Migraine https://n.neurology.org/content/neurology/94/13/e1365.full.pdf Different Dosages regimens of Eptinezumab for the treatment of Migraine: a meta-analysis from randomized control trials https://thejournalofheadacheandpain.biomedcentral.com/track/pdf/10.1186/s10194-021-01220-y.pdf Safety and Tolerability of Eptinezumab in patients with migraine: a pooled analysis of 5 clinical trials (this is the shit that I pay attention to) https://thejournalofheadacheandpain.biomedcentral.com/track/pdf/10.1186/s10194-021-01227-5.pdf

Confederate Railroad, Queen of Memphis “She showed me things I never..out there on the farm” (lol been there). Stars and Bars Ms. Tucker had the pipes This world is too PC for another Waylon, and there will never be another outlaw movement like Waylon on vocals, picking/grinning and Moon on pedal and steel. Oh, and one of my theme songs.

Knowing family and friends that are crop farmers, it's a tough gig, equipment is often 30+ years old, massive debts, hard to get by. My dairy and chicken farmers aren't fairing any better. Mellencamp sang this in the 80s, now much worse. They have social workers in the midwest that travel farm to farm trying to assist them out of the darkness. Not any better around here, during the boom/bust past few decades most just sold the land. We got to eat, and not anyone is raising eyebrows to this. “Rain on the scarecrow blood on the plow.”

And now to make you laugh

Classic Reznor, NIN Take the Power Back

I'm geriatric amongst the dopers (youth) that the demographic this caters to, eff it. The lyrics are great “the deaf man hear what the mute man says.”

I don't care if people discovered them because of a TV show, this is a great one to... and lose all sense of self.